VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1055166
Sex: F
Age: 46
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: NA

Allergies: Antihistamines

Symptoms: Two hours after injection got hives on right palm of hand. Next at exactly the same time was upper arm and armpits, both arms. Inner thighs then got hives, back of leg. I am allergic to Benedryl but had no choice to take it. This morning I had hives on my left wrist and in between all of my fingers. Afternoon: hives on both wrists, inner thighs, and thumbs. Taking Benedryl currently.

Other Meds: Amlodine Losarten Hydrochlorothiazide Sertraline

Current Illness: Sinus infection last week

ID: 1055167
Sex: M
Age: 74
State: CA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: chills, light headache, weakness, tiredness

Other Meds: no

Current Illness: none

ID: 1055168
Sex: M
Age: 65
State: TN

Vax Date: 02/08/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: On 2/20/2021 the pt noticed he had a 4" red itchy rash below the injection site. On 2/25/2021 the rash is still present but no longer itching. Pt has not contacted his PCP regarding his symptoms or taken any meds at this time.

Other Meds: omeprazole 20mg, hydrochlorothiazide 12.5 mg, aspirin 81 mg,

Current Illness: no

ID: 1055169
Sex: F
Age: 49
State: NJ

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: Penicillin, Demerol, dairy (casean), gluten, kiwi fruit

Symptoms: Received "Moderna COVID-19 Vaccine EUA" Red, swollen, orange-peel like skin, itchy patch on same arm as the vaccine injection site. Patch is 4 inches x 4 inches round, located just below the vaccine injection site. Continues through the day, redness intensifying thru the day, itch remains same as the early morning when first observed.

Other Meds: Vitamin B complex, Rhodiola, Rolera, Serenetin

Current Illness: None

ID: 1055170
Sex: F
Age: 60
State: CO

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: antacids

Symptoms: Painful and stiff arm, fever, fatigue, slight headache, body aches and slight constipation all symptoms lasting two and a half days. Used hot compress on arm repeatedly, Tylenol to help reduce fever and body aches, bed rest, and increased water consumption.

Other Meds: Vitamin D, Vitamin B complex, Psyllium husk fiber

Current Illness: none

ID: 1055171
Sex: F
Age:
State: IN

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: No

Allergies: None

Symptoms: High fever, headache, body aches Lasted around 36 hours

Other Meds: Losartan, metformin, meloxicam, simvastatin, alpha lipoic acid, vitamin C, glucosamine

Current Illness: Covid symptoms 3 weeks prior: headache, fatigue, nasal congestion, loss of taste and smell

ID: 1055172
Sex: F
Age: 37
State: NY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: For approximately six hours, fever, chills, headache, body aches. I also had a red itchy rash on the right arm from the bicep to the forearm and, a red itchy rash on the back of both my left and right thighs. These rashes lasted for 5-6 days.

Other Meds: None

Current Illness: None

ID: 1055173
Sex: M
Age: 91
State: NC

Vax Date: 02/01/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: +COVID test

Allergies:

Symptoms: Pt admitted w/ severe COVID diagnosis after receiving 2 doses of vaccine

Other Meds:

Current Illness:

ID: 1055174
Sex: F
Age: 65
State: IN

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: She did not have any reactions initially, but noticed the morning after the vaccine that her regular cup of coffee did not taste good. She then had a rash that started on the left side of her neck, went towards the back now. This started a few days after the vaccine, all on the left side. She also got a cold sore on her lip which she had all the time as a child, but not as an adult, which has pretty much resolved. She has been cold, chills and some dizzy spells. She did get a bump on her head concussion in December. One day last week she just stayed on the sofa with a blanket due to feeling poorly. 3 days ago on her back by her shoulder blade an area has been really sore. She did take some Tylenol for the back pain which did not help so she stopped this. She did not call her doctor. The rash is still there but not as intense. It has not itched, but she has felt it.

Other Meds: Senior multivitamin, B vitamin, Vitamin C, glucosamine chondroitin, liver pill, coconut oil, billberry, baby aspirin, coral calcium, ALC and ALA.

Current Illness: None.

ID: 1055175
Sex: M
Age: 41
State: NC

Vax Date: 02/13/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: When entering the vaccine for today's first dose clinic, I noted that he had already received the first dose on Feb. 13,2021 and he had returned and received a second dose of the same vaccine.

Other Meds: not known

Current Illness: Not known

ID: 1055176
Sex: F
Age: 69
State:

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A delayed cutaneous hypersensitivity reaction at injection site. Redness on whole area of deltoid accompanied by itching. No actual wheal present. Currently still have some redness about half of the area. Some on/off itching at times. Did not take antihistimine.

Other Meds:

Current Illness:

ID: 1055177
Sex: M
Age: 66
State: NJ

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Sulfa, ragweed

Symptoms: pain down length of L arm swelling L arm nerve pain as if carpal tunnel syndrome L arm shooting pain at times in L forearm muscle numbness in tips of fingers L hand sometimes soreness in knuckles or bones of L hand sometimes bone pain in L arm sometime muscle pain in L arm similar to "charley horse" in calf i had gotten when younger Never had any of this before , nor any prior vaccine reaction

Other Meds: Many

Current Illness: n/a

ID: 1055178
Sex: F
Age: 73
State: CA

Vax Date: 02/20/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Large rash on left arm at vaccination site. Soreness, slight swelling and slight itchiness. Rash came on five days after Pfizer COVID 2nd vaccination injection. Rash still present.

Other Meds: Losartan 50 mg; Lorazepam 0.5 mg; Oxybutynin 5 mg; Melatonin 0.5 mg; Fish Oil; Vitamin C

Current Illness:

ID: 1055179
Sex: M
Age: 37
State: KY

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Over a four day period the PTs symptoms consisted of: fever ranging from 103.6-104.1, body aches, chills, and headache.

Other Meds: Tyenol

Current Illness: N/A

ID: 1055180
Sex: F
Age: 76
State: CT

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Macrobid

Symptoms: Complaint of itching rash around injection site and along left upper extremity. Occurred within 24 hours post injection and continues to date.

Other Meds: Synthroid 75 mcg Diazepam 5 mg Daily Multivitamins Tumeric

Current Illness:

ID: 1055181
Sex: F
Age: 75
State:

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccin EUA Injection site reactions : redness, burning, itching. General side effects : fatigue, headache. Dizziness and weakness.

Other Meds:

Current Illness:

ID: 1055182
Sex: M
Age: 33
State: TX

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None, the symptoms went away on their on after 3 or 4 days.

Allergies: Codine possible Penn

Symptoms: No reaction after the injection however, after a little over a week I began having alot of itching, swelling and red blotches along with soreness at the injection site. (Covid Arm) I also was fatigued for a few days.

Other Meds: None

Current Illness: None

ID: 1055183
Sex: F
Age: 31
State: CA

Vax Date: 12/01/2020
Onset Date: 12/26/2020
Rec V Date: 02/25/2021
Hospital:

Lab Data: NA

Allergies: NA

Symptoms: Upper body burning only at night without fever. Onset the night after vaccination date. Lasted for two nights. Extreme fatigue. started a day after vaccination and lasted for 3 days.

Other Meds: OTC Multivitamins

Current Illness: NA

ID: 1055184
Sex: F
Age:
State: IL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: no

Symptoms: low grade fever 100.7, chills and body aches

Other Meds: no

Current Illness: no

ID: 1055185
Sex: F
Age: 50
State: NJ

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe back pain, unbearable to sit or lean back, painful to the touch. Took Advil 24 hours after having the vaccine.

Other Meds:

Current Illness:

ID: 1055186
Sex: F
Age: 36
State: NY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: BP 118/73, PR 55, PO2 98%.

Allergies: None

Symptoms: Felt lightheaded getting up in the observation area. Fell struck head lost consciousness times one minute. Complained of mild headache which cleared while being observed. Drank OJ and vomited it. No further nausea. Denies dizziness, neck pain, double vision, amnesia. Recovered fairly quickly while resting. Felt much better. Refused transport. Taken home by husband with instructions to monitor LOC. Follow up with family MD advised.

Other Meds: Trazadone, Prozac

Current Illness: Post pertem depression; Previous neprectomy for reflux and sepsis

ID: 1055187
Sex: F
Age: 56
State: SD

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Given a shot of benydryl 25mg

Allergies: Allergic to most pain medicine, allergic to pork which is very bad (face tingles and tongue swells, grass (rash all over body), bee stings (site of sting swells and gets hot)

Symptoms: Chest pain, difficulty breathing, tingles in the face, tongue swelling, cold sweats

Other Meds: Tamoxifen, hydrochlorithiazide, Potassium, Lysine (otc), magnesium (otc), turmeric (otc), Bayer 81mg, vitamin D (otc), vitamin B6 (otc), Claritin (otc), Prevacid (otc)

Current Illness: None

ID: 1055188
Sex: F
Age: 58
State: NY

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: motrin, Augmentin, Cephalexin ,Clindamycin, all penicillin, sulfamethoxazolel/trimethoprin, latex gloves

Symptoms: The day after the vaccination had symptoms that effected my work. The symptoms were fever, body/muscle aches, and headache.

Other Meds: Otezla, Vitamin, E, Vitamin D, vitamin C, Loratadine, Fluocinolone Acetonide

Current Illness: None

ID: 1055189
Sex: M
Age: 74
State: AL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No adverse event at this time - patient given 0.6ml instead of the indicated 0.3ml

Other Meds:

Current Illness:

ID: 1055190
Sex: F
Age: 42
State: MN

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: 7 days after injection I've experience a new redness around the side. It is also firm/hard and itchy.

Other Meds: Levothyroxin

Current Illness:

ID: 1055191
Sex: M
Age: 56
State: CA

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: 2/4/21-2/7/21 & 2/10/21-2/13/21: CBC, TB test, CT scan, Lab work, ultrasound of spleen, bone marrow test. Results: low blood count, other tests negative.

Allergies: No known allergies

Symptoms: Fever, bruising on left arm and left leg, fatigue. Went to urgent care, drew labs, low blood count, went to ER. Was given steroids and several plasma transfusions. Was sent home with steroids.

Other Meds: Multivitamin

Current Illness: None

ID: 1055192
Sex: F
Age: 78
State: MA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: chills, dizzyness, nausea, fatigue, light headed, loss of appetite

Other Meds: Lisinopril, Xyljnx, zetia, rovostatin, low dose asprin, pro-biotic, albuterol inhaler, flovent inhaler, flonase

Current Illness: not ill at vaccine time. 1/21/21 sinus infection

ID: 1055193
Sex: F
Age: 35
State: MO

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: SPIDERS, CHIGGERS, MOSQUITOS, WASPS, PENICILLIN, MOLD, BLUE CHEESE.

Symptoms: Patient started having a pounding headache, itching all over. Started to have rash and hives. bp was elevated. she did have epi pin on her but did not want to use it due to previous reaction to epi. 50 mg of benadryl was given in the right deltoid. once this was given symptoms subsided. ems was called, however she declined transfer. She was driven home via a family member

Other Meds: VITAMIN D

Current Illness: NONE

ID: 1055194
Sex: F
Age: 68
State: OH

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 2/24/21 saw audiologist and ENT Physician Steroid injected into left eardrum and prescription for oral steroids. Recommended MRI but have not been scheduled yet. Follow-up visit for second injection scheduled for 3/4/2021.

Allergies: Aspirin

Symptoms: Profound hearing loss in left ear

Other Meds: Lisinopril Atorvastatin Biosoprolol/hctz 5/6.25 mg Multi vitamin Glucosamine

Current Illness: None

ID: 1055195
Sex: F
Age: 34
State: FL

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderna vaccine given on or about 1:40 PM. Patient complained of being dizzy during the mandatory observation time. Nurse was walking her to the recliner then suddenly she stated "I'm dizzier.....I'm dizzy" then she slowly descended to the floor. Nurse STAT was immediately called. She woke up after calling her name, removed her masked and asked to take a deep breath. She responded to all commands. ED nurse stat responded and patient taken to the ED for evaluation via wheelchair.

Other Meds:

Current Illness:

ID: 1055196
Sex: F
Age: 72
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: no

Allergies: Dust; grass

Symptoms: I was feeling chilly and I went to bed early and got under the covers. At 3 in the morning, I had a fever - 99. something and aches and pains. I took ibuprofen. I got up at 7:00 am and my temperature had gone up to 100 something. My body ached really bad. It ached all day long ( and fever continued) and it felt like I had a really bad flu. I called my doctor (telemed appt) and she thought it would be over by 24 hours. It did go away after 24 hours.

Other Meds: Calcium; Vit D; Multiple Vitamin; Forsonipril - high blood pressure; claritin- allergies; Zidia - for cholesterol

Current Illness: no

ID: 1055197
Sex: F
Age: 44
State: IL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: NOne

Symptoms: Patient came in too early for 2nd shot. I inadvertently administered too soon.

Other Meds:

Current Illness: none

ID: 1055198
Sex: F
Age: 74
State: TX

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Heaviness across the chest and harder to get deep breath when needed. Lasted throughout the evening and night but was OK the next morning.

Other Meds: Vit C; Multi Vit; Complex Vit B 12; Turmeric; crestor 5 mg; levothyroxine .125 mcg.

Current Illness: None

ID: 1055199
Sex: F
Age: 54
State: GA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: COVID 19 rapid test on 2/22. Once it was negative got a PCR test which also came out negative

Allergies: Penicillin and Sulfa

Symptoms: Redness and soreness began on night of injection and has continued to grow in scope 5 days in. Fever of 100, 24 hours after injection and continuing for 48 hours. Sniffles 24 - 72 hours after. Tightness in chest - deep breaths hurt for 24-72 hours. Low energy beginning 18 hours after injection and continuing 5 days after. Massive, almost non-stop headache from 8 hours after injection lasting 72 hours.

Other Meds: Zolpidem, Fyavolv, Levothyroxine, Escitalopram, Vitamin B 12, Vitamin D

Current Illness:

ID: 1055200
Sex: M
Age: 35
State: CT

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Pt received his first dose of the Moderna COVID19 vaccine. Within a few seconds he lost consciousness. VS: 103/40 HR 62, Repeat 86/57 Oxygen Sat down to 77%, limited perfusion in fingers. EMS on site for evaluation. Pt laid down, oxygen administered by paramedic, VS began to normalize including pulse ox. Pt reported feeling better, he signed a refusal with EMS as he did not want to go to the ED. Pt was advised he cannot drive himself home. Pt's coworkers agreed to drive him home. Pt was counseled on ED precautions. Pt was also counseled to call his PCP asap to review what happened and discuss plans for next dose. Pt verbalized understanding. Pt did report history of passing out with blood draws but not with vaccines. Pt did not mention this to the vaccinator prior to vaccination.

Other Meds: Unable to view in VAMS

Current Illness: Unknown

ID: 1055201
Sex: F
Age: 68
State: NC

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: left arm soar, right thigh sore, fatigued

Other Meds: metoprolol, atorvastatin, plavix, vitamin d3, dialavite, combigan, , latanoprost, dorzolamide hci

Current Illness: n/a

ID: 1055202
Sex: F
Age: 46
State: TN

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pt left premises and made a u-turn returned to facility c/o itching in nose and airway redness noted in throat no swelling noted O2@100% HR 72 Bil Lung sounds clear to auscultation 122/76 B/P Resp: 20 Benadryl 25 mg po administered remained with pt for additional 30 min. symptoms resolved and pt left premises to return home followed up with pt via text 30 min later pt is safely home denies any further symptoms or concerns

Other Meds:

Current Illness:

Date Died: 02/24/2021

ID: 1055203
Sex: M
Age: 67
State: OH

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Nearly all of CMP and CBC abnormal, lactic acid 24.8, CRP 241, BNP >3000. CT of chest/abdomen reveals pneumonia, acute colitis, cirrhosis.

Allergies: Cat hair extract, Pollen extract, Mold and Smuts

Symptoms: Began having SOB and cough on 2/18/21, the day after his first vaccine. Had a routine physician appointment for diabetes on 2/15/21 with no documentation of these complaints. Presented to the hospital on 2/23, soon after required intubation. Admitted with severe pneumonia, diffuse colitis, and sepsis. Condition continued to worsen until patient passed away on 2/24/21 @ 1632.

Other Meds: Metformin, Lisinopril, Atorvastatin, Aspirin, Dulaglutide, Insulin Glargine, Loratadine, Fenofibrate, Fluticasone, Multivitamin

Current Illness:

ID: 1055204
Sex: M
Age: 74
State: KY

Vax Date: 02/06/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: ESR, CRP normal, MRI normal, pending sleep study

Allergies: Plavix

Symptoms: Change in vision, on exam noted to have swollen right optic disc, MRI normal, likely a secondary non-artertitic ischemic optic neuropathy and further workup is pending.

Other Meds: aspirin 325 mg - 1 tablet by mouth as directed atorvastatin 20 mg - 1 tablet by mouth as directed Centrum Complete 18-400 mg-mcg - 1 tablet by mouth as directed colestipol 1 gram - 1 tablet by mouth as directed ezetimibe 10 mg -

Current Illness:

ID: 1055205
Sex: F
Age: 57
State: GA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: nka

Symptoms: Technician called 2/25 to schedule 2nd Moderna dose when patient stated that she had a reaction a day after receiving the vaccination: unspecified pain (pain scale 9) around rib cage (breast line to waist) - saw urgent care as well as PCP and was prescribed Diclofenac tabs, muscle relaxer. Patient also takes Tylenol and intermittent Motrin - does not seem to help. I advised the patient to return to PCP for further clinical evaluation. Patient stated she is unable to work since 2/17/2021

Other Meds: unknown

Current Illness: unknown

ID: 1055206
Sex: F
Age: 56
State: NY

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Allergic to peanuts, pine nuts, brazil nuts

Symptoms: A week after vaccination, yesterday, I started to develop intense itching, redness, swelling, and induration at and around the injection site. The area has continued to grow and is now, 24 hours later, about 10 inches long and 4 inches wide.

Other Meds: Combination hormone replacement therapy, calcium/vitamin D supplement

Current Illness: None

ID: 1055207
Sex: F
Age: 21
State: TX

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Ant venom

Symptoms: Severe breathing difficulty. Lasted 9 days which required use of albuterol inhaler every ~4-6 hours for the first 7 of the 9 days. Breathing difficulty slowly went away over many days after the first 7-9 days. Resting heart rate was also elevated (near 130-140) as well as lightheaded feeling for a few days when breathing difficulties were most severe. Now breathing is back to normal.

Other Meds: Birth control

Current Illness:

ID: 1055208
Sex: F
Age: 47
State: UT

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: Sulfa and Minocyline.

Symptoms: I am confused like I get with UTIs.

Other Meds: Armour thyroid, Levothyroxine, Lyrica and Opioid pain management, B12, Estrogen and Progesterone.

Current Illness: Only chronic conditions.

ID: 1055209
Sex: F
Age: 67
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Penicillin Codeine

Symptoms: 8:55 patient complained of feeling anxious, fluttering in chest per patient this is not new, history of Mitral valve prolapse, Diabetes mellitus and COPD. Lost her spouse on this day, feeling anxious. 9:15- 128/60 Pulse 84, respiration 70, 97% saturated Patient denied chest pain or shortness of breath. No sign of distress observed. 9:30 -Patient instructed to call EMS for chest pain and shortness of breath, fluttering, contact Primary care provider. Patient verbalized understanding and drove home.

Other Meds: Insulin, CoReg, Crystal, Carvedilol

Current Illness:

ID: 1055210
Sex: F
Age: 78
State: HI

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none. Dr. saw reaction 2/5/2021

Allergies: Environmental allergies-mold, pollen, dust, etc. Food-high allergies, Lactose intolerant, cheese with mold in it, cream cheese like Feta and Roquertfort; medium allergy to mustard, sesami seeds, chili, certain beans. 80 American Patch test - allergic contact dermatitis to Neomycin sulfate, Potassium dichromate, Nickel sulfate hexahydrate, 2-tert-Butyl-4-methoxyphoneol (BHA), Gold (I) SodiumThiosulfate dihydrate and Colbalt (II) chloride hexahydrate. Tolerates titanium and platinum metal jewelry without metal alloys.

Symptoms: Evening of 1/28 I started feeling fatigue, muscle aching, stomach upset and headache which lasted till next day around noon. Then was fine for 7 days. On 2/5/2021, I went to get my B12 shot and asked the doctor to check left arm where Moderna shot was given as it was itching and a bit sore at the same time. He told me I was having reaction. By evening, a third of my arm around injected area was swollen an had red rash. Then same symptoms of fatigue, etc. came back and I was in and out of bed for the next three days....then at end had a bout of diarrhea.

Other Meds: Losartan 100mg for HBP. Vitamins and minerals. Calcium, Vitamin K, krill oil.

Current Illness: No illness but had Lasik surgery and YAG Capsolotomy Laser surgery in left eye to correct problems from cataract surgery in October.

ID: 1055211
Sex: F
Age: 74
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: PT dose was 1.8 MLS not 0.3MLS.

Other Meds:

Current Illness:

ID: 1055212
Sex: F
Age: 77
State: OH

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Ceften, Augmentin, Sulhamethos, Lipitor, Lisiniprill Leviquin , Clarithromyc, Meloxicam

Symptoms: First Day arm sore, fatigued and cough. Second day Chills and Fever, Body Aches, Headache, Nausous, couldn't eat or drink, Arm sore and swollen, very fatigued, slept all day. Third day a little better, Fourth day fine.

Other Meds: Allegra 60 mg, Amlodipine 5mg, ASPRIN 81 mg, Azelastyine nasal spray, Celebrax 200 mg, Clopidogrel 75 mg, Estradiol 1 mg, Ezetimibe 10 mg, Fluticasone Nasal Spray, Hydrochlordthiazide 25 mg, Livalo 4 mg, Losartan 100 mg, Mtoprolol Tartate

Current Illness: None

ID: 1055213
Sex: F
Age: 65
State: MS

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Area below injection site red, swollen, very itchy, and warm to touch. Swollen area about 5 inches by 4 inches. Driving me crazy so itchy.

Other Meds:

Current Illness:

ID: 1055214
Sex: F
Age: 77
State: CO

Vax Date: 12/30/2020
Onset Date: 01/10/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None reported

Allergies: scopolamine, aspirin, ibandronate, diphtheria-tetnus-pertussis vaccine, fluticasone, hydrocodone-acetaminophen, oxycodone, tamoxifen, varicella zolster vaccine, adhesive, anastrozole, lactose, penicillin, sulfa, tamoxifen, tetracycline

Symptoms: Moderna COVID- 19 Vaccine EUA: patient reported a small, raised, and hard area at the injection site 14 days after vaccination that started 11 days after vaccination. During clinic visit 15 days after vaccination lymphadenopathy, erythema, and itching documented and patient reported symptom improvement. Eight days later at annual wellness visit no symptoms reported.

Other Meds: boric acid, calcium carbonate, vitamin D3, estradiol, metronidazole, nitrofurantoin, simvastatin, tetrahydrozoline/polyethylene glycol eye drops

Current Illness: anemia

ID: 1055215
Sex: F
Age: 83
State: IL

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: On 02/18/2021 pt got up and said she felt like a "mac truck had run her over". Every part of her body hurt. She had chills and a fever. she was unable to eat. This lasted until Sunday, 02/21/2021. She started to feel better on Sunday and Monday. Then on Tuesday, 02/23/2021 when she woke up she was unable to walk, she did not have feeling in her hands and was in extreme pain. She was taken to her PCP. She stayed with her daughter until 02/25/2021 when she finally started to feel better. Her Cardiologist was also called and informed.

Other Meds:

Current Illness: NONE

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm